Developmental Course of Childhood Dysarthria – A Longitudinal Study

Research Question: More than 50,000 children in Germany live with dysarthria. To date, however, studies on the clinical characteristics of childhood dysarthria are scarce. In particular, little is known about the developmental course of speech functions in affected children. We present a longitudinal study on neurologically affected children. Manifest forms of dysarthria were analysed throughout the developmental process to investigate if children with dysarthria benefit from developmental dynamics and may accordingly approximate their respective age norm. In children with uncertain dysarthria diagnosis, perceptually salient characteristics of speech (e.g., harsh-breathy voice) will be identified as either physiological or pathological through the longitudinal analysis.

Methods: We assessed 14 children (various aetiologies, with and without dysarthria diagnosis; 10 m; 5;1 – 8;4 years; months) at two times within an interval of nine months. Speech samples were elicited by assessment materials specifically developed for this study. They were analysed perceptually using the diagnostic criteria of the Bogenhausen Dysarthria Scales. This longitudinal study is part of a larger project, which provides dysarthria-related norms from 140 typically developing children (70 m, 3–9 years; cf. submission by Schölderle et al.). Comparisons of the neurologically affected children with this typically developing group allowed us to set the developmental courses against the background of age-specific norms and thereby differentiate between age-appropriate physiological characteristics and specific symptoms of dysarthria.

Results: We documented different developmental trajectories in children with manifest, more severe forms of dysarthria. Whereas some children were able to benefit from developmental dynamics and improved significantly, others only showed marginal progress and therefore moved further away from their age-norms. Similarly, children with more circumscribed features also showed different developmental trajectories. We observed an approximation towards the norm in several cases, which caused us to drop a dysarthria diagnosis. Other children showed no improvement, that is, the distance to their norm increased. Accordingly, their speech characteristics were classified as dysarthric symptoms.

Discussion: Children with dysarthria form a very heterogeneous group. We will discuss associations between different developmental courses and factors such as GMFCS or concomitant language impairment. Profound knowledge about developmental trajectories and about symptoms of childhood dysarthria that manifest only with increasing age, can contribute to an improved clinical diagnosis.

Conclusion: Our study is the first longitudinal investigation on childhood dysarthria. It may support a deeper understanding of the disorder and pave the way towards a standardised assessment of affected children.

References

1. Haas E, Ziegler W, Schölderle T. (2017). Eliciting speech from children with dysarthria: a new approach for clinical assessment. 7th International Conference on Speech Motor Control. Juli 2017, Groningen, Niederlande.

2. Morgan AT, Liégeois F

No conflict of interest has been declared by the author(s).